Modified Joel-Cohen technique for caesarean delivery

Objective To investigate whether a series of changes in the current caesare an section operative routine, based on new knowledge, would be beneficial. Design A prospective controlled trial. Setting Labour ward with approximately 3000 deliveries annually in a suburb an area of Gothenburg, Sweden. Participants Seventy-two pregnant women scheduled for delivery by caesarean section were randomised to either modified Joel-Cohen technique (n = 36) o r Pfannenstiel technique (n = 36). Main outcome measures Blood loss during surgery and operating time. Results The median estimated intra-operative blood loss was 250 mt in the m odified Joel-Cohen group and 400 mL in the Pfannenstiel group (P = 0.026). The proportion of women with greater than or equal to 300 mt was 16/36 in t he modified Joel-Cohen group vs 28/36 in the Pfannenstiel group (OR 0.229, 95% CI 0.082-0637). Median operating time was 20 min in the modified Joel-C ohen group compared with 28 min in the Pfannenstiel group (P < 0. 001). The proportion of women with greater than or equal to 25 min was 1/36 in the m odified Joel-Cohen group vs 33/36 in the Pfannenstiel group (OR 0.003, 95% CI 0.000-0.026). Conclusions We conclude that the modified Joel-Cohen technique of caesarean delivery reduced intraoperative blood loss and operating time compared wit h the Pfannensriel technique.